I think Obama himself recognized that the Pharma lobby is one of the hardest to beat, and decided to try and sidestep them in trying to improve access to health

I think Obama himself recognized that the Pharma lobby is one of the hardest to beat, and decided to try and sidestep them in trying to improve access to healthcare. Clinton tried and failed due to the Pharma lobby, Bush passed Medicare Part D but wasn't able to give CMS price negotiation power. It's really quite unfortunate for healthcare consumers.